Role Of Colchicine Research Articles

Effusive Constrictive Pericarditis

Effusive constrictive pericarditis (ECP) is a relatively infrequent pericardial condition. The diagnosis is typically made when symptoms and right heart pressure elevation persist despite drainage of pericardial effusion. Visceral and parietal pericardial stripping is an extensive procedure with significant morbidity and mortality but is widely considered the only effective treatment. Recent studies suggest that up to 10% of constriction may be reversible, and a newer series has reported spontaneous complete resolution of symptoms in a subset of ECP patients. In this review, the authors describe 2 patients with ECP who were managed successfully with steroids and colchicine, respectively, thus obviating the need for surgery. The authors also review the current understanding of this reversible pericardial pathology and explore the possible role for colchicine in treating this condition.

Prevention of chronic cyclosporine nephrotoxicity in Sprague Dawely rats: role of colchicine and omega-3-fatty acids

Prevention of chronic cyclosporine nephrotoxicity in Sprague Dawely rats: role of colchicine and omega-3-fatty acids

Changes in serum carbonyl and malondialdehyde levels following colchicine and vitamin E treatment in Behçets disease

Behcet's disease (BD) is an inflammatory disorder of an unknown cause, but growing evidence indicates that the oxidative stress is increased in BD, owing to the overproduction of reactive oxygen species (ROS) and decreased efficiency of antioxidant defenses. ROS affect proteins and lipids and cause their oxidation, therefore, contributing to the formation of oxidation products: carbonyl, a marker of protein oxidation, and malondialdehyde (MDA), a marker of lipid peroxidation. The investigation was undertaken to evaluate protein oxidation (carbonyl group) levels and lipid peroxidation (MDA) levels, and the role of colchicine and vitamin E therapy on protein carbonyl group and MDA levels in serum samples of patients with BD. In this study, subjects were classified as control group, colchicine therapy group alone and colchicine and vitamin E therapy group. Protein carbonyl and MDA levels at the beginning of the study were significantly (p < 0.05) higher in both therapy groups compared with those of the control group. We found that the protein carbonyl and MDA levels at the end of the study showed no significant (p > 0.05) differences between the therapy groups and control group. These results provide some evidence for a potential effect of colchicine and vitamin E therapies on increased protein oxidation and lipid peroxidation in BD.

Remission of Recalcitrant Epidermolysis Bullosa Acquisita (EBA) with Colchicine Monotherapy

A 42-year-old woman with widespread recalcitrant epidermolysis bullosa acquisita (EBA) responded well to colchicine monotherapy after attempts to control her disease with other modalities failed. These included dapsone, tetracycline, prednisolone, and combination of cyclophosphamide/azathioprine with dexamethasone 'pulse therapy'. The useful role of colchicine in controlling some difficult cases of EBA, a therapeutically problematic condition, is stressed.

Efficacy of colchicine in patients with primary biliary cirrhosis poorly responsive to ursodiol and methotrexate

Objective Approximately 20–30% of patients with primary biliary cirrhosis (PBC) respond fully to treatment with ursodeoxycholic acid (UDCA). The rest have progressive disease and eventually develop cirrhosis and liver failure. More effective treatment is needed. Methotrexate improved biochemical tests of liver function and liver histology in patients with PBC who had failed to respond to UDCA in one report and induced sustained biochemical and histological remission in another. The role of colchicine in PBC is unclear. We describe three patients with symptomatic PBC who responded very well to the addition of colchicine after they had failed to respond to UDCA alone and in combination with methotrexate. We suggest that colchicine should be tried in PBC patients who clearly fail to respond to UDCA. Methods Three patients with symptomatic biopsy-proven, antimitochondrial antibody-positive PBC failed to respond to UDCA and then to the addition of methotrexate. Colchicine was eventually added to the regimen. Symptoms, biochemical tests of liver function, and percutaneous liver biopsies were done at baseline, after treatment with UDCA, UDCA plus methotrexate, and UDCA plus methotrexate plus colchicine. Results All three patients responded after colchicine was added to UDCA and methotrexate. Symptoms, biochemical tests of liver function, and liver histology improved in all, and blood tests normalized in two. Conclusions Colchicine may be effective treatment in some symptomatic patients with PBC who respond incompletely to UDCA alone or in combination with methotrexate. Colchicine may be tried in such patients.

Diagnosis and Treatment of Gout in the Intensive Care Unit

Gout is a common cause of arthritis resulting from formation of monosodium urate crystals in synovial tissues. The incidence of this condition in the critically ill population is unknown, but gout can result in short-term morbidity and it can occasionally complicate management of a patient's primary condition. The diagnosis of gout should be considered in any patient in whom acute arthritis or bursitis develops. Aspiration of the involved joint or bursa and identification of crystals using either polarized or light microscopy are mandatory. Treatment options in critically ill patients differ from the usual treatment of gout because most critically ill patients have or are at risk for renal dysfunction and gastrointestinal bleeding, thus making use of nonsteroidal anti-inflammatory agents and colchicine hazardous. Intravenous colchicine in critically ill patients should be used with extreme caution, if at all, because the risk of bone marrow toxicity and other complications are well described in this patient population. Initial regimens should include use of adrenocorticotropic hormone, intra-articular corticosteroids, or systemic steroids. Analgesics may be beneficial as primary therapy in minor cases of acute gout, and they may be useful as adjunctive therapy in more severe cases. The role of colchicine as a prophylactic agent is discussed, as are treatment options in the allograft transplant population, in which rapidly progressive gout is increasingly common.

Gouty arthritis and uric acid metabolism.

Important observations have continued to expand our understanding of gout. The increased risk of gout in black Americans has been linked more closely with the development of hypertension, and an increasing prevalence in African blacks and in England may have a similar association, possibly through the use of diuretics. The association of gout and insulin resistance appears to be related to fat distribution, and the link with hyperlipidemia may be related to genetic factors. The relationship between gout and renal disease and the frequency of gout in patients with renal failure continue to be areas of controversy. The mechanism and a possible therapeutic approach to the hyperuricemia associated with cyclosporine therapy are better understood. The potential for antibodies against urate crystals to potentiate further crystallization may explain some of the uncertainties about gouty attacks. Unusual manifestations of gout, including more cases of spinal involvement, were reported. The role of formalin in dissolving urate crystals in pathologic specimens was further clarified, and the use of atomic force microscopy to detect crystals was reported. Corticosteroids are increasingly accepted in treating acute gout, and the role of colchicine in acute and intercritical gout has come under increasing scrutiny. Urate-lowering drugs appear to be cost effective in patients with more than one or two attacks per year.

Amyloid proteins and amyloidoses: complexity updated.

Amyloid is a beta-pleated fibrillar protein principally constituted of light chains of immunoglobulins (kappa or lambda) in primary or myeloma-associated amyloidosis, of AA proteins in secondary amyloidosis and familial. Mediterranean fever, and of variants of prealbumin - now called transthyretin - in senile amyloidosis and in familial polyneuropathies. Other identified amyloidogenic proteins involve APUD protein derivatives (calcitonin), beta 2 microglobulin in chronic hemodialysis-related amyloidosis and beta protein in Alzheimer disease. After a short review of experimental findings and theories concerning the pathogenesis of amyloid deposition, the clinical aspects of amyloidosis are discussed stressing their great diversity. The diagnostic approach is also examined, with particular emphasis on rectal and kidney biopsy and subcutaneous adipose tissue aspirates. Finally, some comments on the treatment of amyloidosis (role of colchicine and DMSO) are made.

A Role for Colchicine in Treating Familial Mediterranean Fever?

A Role for Colchicine in Treating Familial Mediterranean Fever?

Studies on induced tetraploid in four diverse cultivars of pea (Pisum sativum L.).

Tetraploids were induced through colchicine treatment of 1.5-2.0 cm long seedlings in four pea cultivars, namely, T 163 (indigenous), 68 C (W. Germany), 5064-S (Sweden) and P. I. 280064 (Canada). Four hours treatment with 0.025% colchicine produced 10-15% tetraploids. Large seeded cultivars, T 163 and 68 C gave more tetraploids than small seeded ones. Tetraploids showed siginficant varietal differences and were characterised by large stomata, flowers, seeds and pod width and delayed flowering and maturity by 10-15 days while stomata frequency and pod length showed reduction. Both bivalents and quadrivalents were prominent in tetraploid. Chromosome abnormalities were more in T 163 tetraploid (55 per cent cell); laggards were frequent. Pollen and ovule sterility were parallel and ranged from 33 to 85 and 24 to 80 per cent in tetraploid as compared to 0.7 to 5.0 and 0.5 to 3.2 per cent in diploid, respectively. Colchicine treated diploids also showed high pollen and ovule sterility ranging from 16 to 56 and 7 to 56 per cent, respectively but had no chromosome abnormality. The possible role of colchicine and chromosomal abnormalities in reducing fertility were discussed.

Beneficial effects of colchicine in experimental nephrotoxic serum nephritis in the rat.

Glomerulonephritis was induced in rats by multiple injections of rabbit anti-rat kidney serum. Colchicine was administered daily for 4 months to nephrotoxic serum treated rats and untreated control animals. Nephritic rats receiving colchicine had significantly less proteinuria and less glomerular damage than unprotected nephritis animals. A possible role for colchicine in the early treatment of human glomerulonephritis is suggested.

Modulation of the effect of colchicine and cytochalasin B on fibroblast aggregates by the substratum.

In previous investigations, we have shown that aggregates of normal human fibroblasts displayed a remarkable number of morphogenetic properties in suspension and on a substratum. The present investigation has attempted to illustrate more clearly the role of colchicine- and cytochalasin-sensitive structures in the observed ultrastructural properties of the fibroblasts in this system. Cytochalasin B and colchicine alter the surface ultrastructure of the cells as well as the behaviour of the cells during aggregate outgrowth. In addition, the effects of both drugs on the cells in the aggregates are modulated by the attachment of the aggregates to a substratum.